Determining the Prevalence of Bacterial Vaginosis & Vulvovaginal Candidiasis among Married and Unmarried Women & Evaluating the Association Socio-Demographic Risk Factors & Symptoms-Related Variables in Women Attending Gynecology Clinic in Hargeisa Group Hospital, Hargeisa City, Somaliland

Abstract

Background: Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in women of all ages, with one-third of women having at least one form of vaginitis at some time during their lives. The vagina is the muscular passageway between the uterus and the external genital area. When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur. The most common types of vaginitis are: Candida or “yeast” infection, Bacterial vaginosis, Trichomoniasis vaginitis. Objectives of Study: Therefore, the present study was carried out to determine the prevalence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) among married and unmarried women and evaluate the association socio-demographic risk factors and symptoms-related variables in women attending gynecology clinic in Hargeisa group hospital. Methodology: A total of 150 married and unmarried women were investigated & diagnosed by a researcher in Hargeisa Group Hospital, Hargeisa City, Somaliland for determining of VVI prevalence in the present study. Vaginal swabs from these patients were processed for detection of bacterial vaginosis (BV), VVC and trichomoniasis based on guidelines of management of vagina infection. Species specific distribution of VVC was assessed by cultured of Candida on differential agar media, Germ tube test, rice meal agar and carbohydrates fermentation test and BV diagnosed by using gram staining test and biochemical testes. The nurse interviewers performed a comprehensive review of patients and completed the standardized baseline questionnaire containing information regarding the association socio-demographic risk factors and symptoms-related. Results & Discussion: The findings of the present study indicate that VVC was the most prevalent infection with 68 (45%) followed by BV 43 (29%). However, no case of trichomoniasis was detected. Candida albicans was found to be the most prevalent species with 47 (60.3%). Out of non-albicans Candida (NAC) species, C. tropicalis was found to be 9 (9.9%) and C. glabrata 7 (12.2%). On the other hand, the results of present study indicated that BV species Gardnerella vaginalis was most causative with 22 (19.5) and Lactobacillus spp. was 14 (9.3%). These results were also confirmed by gram staining test and biochemical testes. When VVI was compared among married and unmarried women, VVC was more prevalent in married women 47 (31.96) while, BV was more prevalent in unmarried women with 32 (13.76), discussed these results detected that prevalent found most highly with VVB and BV while, no case of trichomoniasis was detected. These findings are in consonance with various previous studies which have indicated VVC & BV to be the most prevalent in VI. Furthermore, the study showed statistical significant difference (P 0.005) & relationship among prevalence of VVV & BV and some socio-demographic risk factors and some symptoms which have been identified as causes of variation in the prevalence rates of bacterial vaginosis & vagina candidasis. Conclusion: VVC was the most prevalent VVI followed by BV in Hargeisa City. C. albicans was the most prevalent species in VVC while among BV species, Gardnerella vaginalis was found to occur at highest frequency. However, further studies are needed to assess specific diagnosis and role of clinical risk factors. Urgent action is required to improve vagina infection control measures to reduce the prevalence and make new policies for treatment of vagina infection in HGH.